Best Practice Case Studies-Case 132 Asset 2 Asthma vs. EIB

Video Transcription

Video Summary

Dr. Jeff Dreher presented a lecture on evaluating exercise-induced dyspnea in athletes, focusing on how to distinguish asthma, exercise-induced bronchoconstriction (EIB), and exercise-induced laryngeal obstruction (EILO). He reviewed a broad differential for shortness of breath, including cardiac, blood, structural, deconditioning, and psychological causes, emphasizing the importance of detailed history, timing of symptoms, triggers, and physical exam.<br /><br />Asthma was described as a chronic, variable, reversible airway disease with inflammation and hyper-responsiveness. Diagnosis relies on spirometry showing obstruction and a greater than 12% improvement in FEV1 after bronchodilator, or other supportive testing such as peak flow variability or methacholine challenge. Treatment follows a stepwise approach from as-needed albuterol to inhaled corticosteroids and combination therapies, with education and action plans being essential.<br /><br />EIB was presented as a separate but overlapping condition, caused by exercise-triggered transient airway narrowing. Diagnosis is based on a greater than 10% fall in FEV1 after exercise or hyperpnea challenge. Management includes warm-up strategies, trigger control, and pre-exercise albuterol, with inhaled corticosteroids or other controllers if symptoms persist.<br /><br />EILO was briefly discussed as inspiratory upper-airway obstruction, diagnosed by laryngoscopy during exercise and treated mainly with breathing/speech therapy.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 132

Topic HEENT

Keywords

4th Edition

4th Edition, Case 132

HEENT

exercise-induced dyspnea

asthma

exercise-induced bronchoconstriction

EIB

exercise-induced laryngeal obstruction

EILO

spirometry

bronchodilator response

laryngoscopy